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Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis

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  • Leah Y Carreon
  • Steven D Glassman
  • Christopher I Shaffrey
  • Michael G Fehlings
  • Benny Dahl
  • Christopher P Ames
  • Yukihiro Matsuyama
  • Yong Qiu
  • Hossein Mehdian
  • Kenneth M C Cheung
  • Frank J Schwab
  • Ferran Pellisé
  • Khaled M Kebaish
  • Lawrence G Lenke
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STUDY DESIGN: Longitudinal cohort.

OBJECTIVES: To identify variables that predict 2-year Short Form-36 Physical Composite Summary Score (SF-36PCS) and the Scoliosis Research Society-22R (SRS22-R) Total score after surgery for complex adult spinal deformity.

SUMMARY OF BACKGROUND DATA: Increasingly, treatment effectiveness is assessed by the extent to which the procedure improves a patient's health-related quality of life (HRQOL). This is especially true in patients with complex adult spinal deformity.

METHODS: The data set from the Scoli-Risk-1 study was queried for patients with complete 2-year SF-36 and SRS-22R. Regression analysis was performed to determine predictors of 2-year SF-36PCS and SRS-22R Total scores. Factors included were sex, age, smoking status, body mass index, American Society of Anesthesiologists (ASA) grade, Lower Extremity Motor Score improvement, indication for surgery, preoperative and 2-year maximum coronal Cobb angles, number of prior spine surgeries, number of three-column osteotomies, number of surgical levels, number of surgical stages, lowest instrumented level, presence and type of neurologic complication, and number of reported serious adverse events.

RESULTS: Of 272 cases enrolled, 206 (76%) cases were included in this analysis, 143 (69%) females, and mean age of 57.69 years. Factors that were significantly associated with of 2-year SF-36PCS were age (p < .001), ASA grade (p < .001), maximum preoperative Cobb angle (p = .007), number of three-column osteotomies (p = .049) and type of neurologic complication (p = .068). Factors predictive of 2-year SRS-22R Total scores were maximum preoperative Cobb angle (p = .001) and the number of serious adverse events (p = .071).

CONCLUSIONS: Factors predictive of lower 2-year HRQOLs after surgery for complex adult spinal deformity were older age, higher ASA grade, larger preoperative Cobb angle, larger numbers of three-column osteotomies, and the occurrence of both neurologic and nonneurologic complications. Most of these factors are beyond the control of surgeons. Still, surgeons should medically optimize a patient prior to surgery to minimize the risk of complications and offer the best chance of improving a patient's quality of life.

LEVEL OF EVIDENCE: Level II. Prospective cohort.

Original languageEnglish
JournalSpine Deformity
Volume5
Issue number2
Pages (from-to)139-144
Number of pages6
DOIs
Publication statusPublished - Mar 2017

    Research areas

  • Journal Article

ID: 52756942